Modic改变分型的慢性非特异性腰痛的推拿近期疗效  

Short-term Efficacy Treated with Manipulation for Patients with Chronic Non-specific Low Back Pain based on Classification of Modic Changes

作　　者：袁仕国[1,2] 张志伟[2] 徐明奎 周理[2] 黄坚[2] 陈美雄[2] 李义凯[1] 

机构地区：[1]南方医科大学中医药学院,广州510515 [2]海南省中医院,海口570203

出　　处：《世界科学技术-中医药现代化》2014年第10期2102-2105,共4页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委面上项目(30171184):旋转手法对腰椎内外结构位移和内在应力影响的实时监测研究;负责人:李义凯

摘　　要：目的:探讨不同类型Modic改变的慢性非特异性腰痛(CNLBP)的传统推拿手法治疗的近期疗效。方法:前瞻性分析推拿治疗CNLBP患者82例,根据MRI中Modic改变分4组:A组Modic 0型43例;B组Modic I型13例,C组Modic域型20例,D组Modic芋型6例。所有患者均采用统一的推拿治疗。同时采集患者一般资料、治疗前后汉化Oswestry功能障碍指数(ODI),并采用IBM SPSS20.0进行统计分析。结果:4组间患者性别、年龄、腰痛时间、治疗前ODI等差异无统计学意义。与同组治疗前比较,治疗后4组ODI明显减小(P<0.01)。A和B之间、C和D之间ODI评分差异无统计学意义,其余组间差异均有统计学意义(P<0.05)。结论:CNLBP Modic改变是影响临床疗效的原因之一。无Modic改变和Modic I型CNLBP比Modic域、芋型患者的推拿近期疗效好,提出Modic域、芋型患者需要考虑叠加其他疗法。This study was aimed to investigate short-term efficacy treated with traditional manipulation for patientswith chronic non-specific low back pain（CNLBP） based on the classification of Modic changes. Eighty-two caseswith CNLBP treated with traditional manipulation were analyzed prospectively. Cases were divided into 4 groupsbased on the classification of Modic changes in MRI. Forty-three cases in group A were Modic type 0; 13 cases ingroup B were Modic type Ⅰ; 20 in group C were Modic type Ⅱ, and 6 cases in group D were Modic type Ⅲ. Allpatients were treated with traditional manipulation uniformly. Meanwhile, general data and Chinese Oswestry disabili-ty index（ODI） before and after treatment were collected. IBM SPSS 20.0 was used in the statistical analysis. The results showed that there were no statistical differences on the gender, age, time of pain, and pretreatment ODI among4 groups. Compared to the pretreatment of the same group, the ODI was obviously decreased in four groups（P〈0.01）. There were no statistical differences on ODI between A and B, C and D. There were statistical differences among other groups（P〈0.05）. It was concluded that Modic change was one of the causes which influence the efficacy of CNLBP patients. Efficacy was better in Modic types 0 and Ⅰ than Modic type Ⅱ and Ⅲ. It was suggestedother treatment methods should be considered to use for patients of Modic type Ⅱand Ⅲ.

关 键 词：慢性非特异性腰痛 推拿 MODIC改变 汉化Oswestry功能障碍指数 康复 

分 类 号：R681.5[医药卫生—骨科学]